Most heart attacks are caused by lifestyle factors, not by genes, and the prevention of heart attacks depends far more on what you do now than what you did earlier in your life.
It is an incredible tragedy that many physicians prescribe statin drugs to prevent heart attacks without also explaining the importance of lifestyle changes. Doctors are too busy to take the time to teach their patients, and many heart attack victims are guilty of not making the necessary lifestyle changes because they are not sufficiently motivated to improve their diet, to exercise and control their weight.
Steve Nissen of the Cleveland Clinic, an advocate of statins, recently said, “There is no diet that’s been shown to reverse heart disease.” Dean Ornish of the University of California, San Francisco, and Kim Williams of Rush Medical College in Chicago quickly responded, stressing the importance of lifestyle changes to get rid of plaques that are already in a person’s arteries (MedPageToday, Sept 8, 2017).
More than forty years ago, Dr. Robert Wissler of the University of Chicago showed that plaques are reversible in animals (Annals of the New York Academy of Sciences, August, 1976;275(1):363-378) and soon afterwards multiple studies showed that plaques are also reversible in humans, even in those who have already had heart attacks (Circulation, 1981;64:1).
Statin drugs help to prevent heart attacks, but CT x-rays showed that plaques already in arteries can be reduced markedly in just one year with lifestyle changes, while the control group who took drugs and did not change their lifestyles had increased plaques (Lancet, July 21, 1990 336(8708):129-133). The difference in the two groups was even greater after five years, and those who did not follow the lifestyle changes had 2.5 times as many heart attacks within the study period. Those who followed all the lifestyle rules had a much greater reduction of their plaques than those who followed just some of the rules. Their PET scans showed 400 percent improvement in blood flow to their hearts after five years (JAMA, Sept 20, 1995;274(11):894-901).
How Plaques Form and Lead to Heart Attacks
First, you develop an ulcer in the inner lining of your arteries. Then you bleed and a clot forms over the ulcer. Next, calcium deposits in the area and a plaque forms over the clot.
A plaque can break off from the inner lining of an artery that brings blood to the heart. That area bleeds and then a clot forms where the plaque broke off. The clot continues to grow until it blocks the flow of blood completely, and the part of the heart muscle deprived of oxygen dies, which is a heart attack.
A Simple Test to Check for Plaques in Arteries
A calcium score X ray (CT scan) measures calcification in arteries and can show whether your arteries are full of plaques (Zeitschrift Fur Kardiologie, 2000. 89(Suppl. 2):135-139). The test is inexpensive, non-invasive and can be repeated to show whether your current treatment is causing your plaques to disappear.
Lifestyle Changes for Prevention and Long-term Treatment of Heart Attacks
- eat lots of plants: fruits, vegetables, nuts, whole grains, beans and other seeds
- drink sugared drinks or fruit juice only during exercise, never when you are not exercising
- avoid foods with added sugars
- avoid red meats, processed meats and fried foods
- avoid being overweight
- control high blood pressure
- do not smoke
- markedly restrict or avoid alcoholic drinks
- keep blood levels of hydroxy vitamin D above 20 nmol/L
- exercise daily. If you are not currently exercising, start an exercise program that is approved by your doctor.
Caution: Exercise can cause a heart attack in a person who has blocked arteries or heart damage. Check with your doctor before you start a new exercise program or make a sudden increase in the intensity of your existing program.
Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.