"Why We Are Not Dying of Heart Disease?" by Allen Weiss, MD, CEO & President

Dr. ALlen Weiss, MD, MBA, FACP, FACR
(September 1, 2007) - According to a recent article in the New England Journal of Medicine, the chance of dying from a heart attack has been decreasing since 1968. What is the cause of this surprising trend, considering that we are the fattest nation in the history of civilization, and with the highest number of people suffering from diabetes?

The primary reason is that some of the major risk factors -- such as smoking, elevated cholesterol and high blood pressure -- have been greatly reduced and are, to a considerable extent, being controlled. People are exercising more than ever, which lowers cholesterol and blood pressure. The exercise trend is evidenced, locally, by the more than 8,000 members of the NCH Wellness Centers, as well as the countless numbers who are involved in other forms of staying in shape. Taking care of oneself is fundamental to any health issue.

The other major reason has been the significant progress made in the care of heart disease, in communities across the nation. Here in Naples, the NCH Healthcare System inaugurated its Save-A-Heart program back in 2000, which has reduced the chance of dying from a heart attack by two thirds. The 500-plus patients who have open heart surgery – also known as coronary bypass surgery -- at NCH have an above average chance of doing well, as measured objectively by HeathGrades, the country's leading healthcare rating company.

Cholesterol lowering drugs such as the “statins”, have also played a major role in the lowered risk of heart attack. Additionally, in the last three years, drug-eluting stents – that is, stents that have been coated with drugs designed to slow cell growth around the stent -- have made a difference by decreasing the chances of having a heart attack or needing another stent. Prior to three years ago, many of the stents available would become narrowed with time, necessitating a replacement stent. Having a drug-eluting stent, although not perfect, has decreased the likelihood of needing another procedure in the future particularly with patients who are compliant with their diet, exercise and medications.

So, which has played a greater role in reducing the risk of heart disease: taking care of yourself or the newer medical and surgical therapies? Research at the U.S. Centers for Disease Control and Prevention, as well as institutions in Great Britain, reveals that they are equally important. Careful statistical analysis over this almost forty year period shows the evolution of therapy, and the awareness that we are responsible for our own health. Combining both attributes has made a significant difference in what had been the major cause of death in modern society.

The cost savings is in the billions, in terms of misery avoided, disability and actual contributions to society, for all the lives spared. We can and should be able to do even better as we go forward. Care for yourself and shop for the best care which is based on objective quality.

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.