From the office of Robert S. Grimshaw Jr MD FACP Internal Medicine 3535 Hill Blvd Yorktown Hts NY 914 962-3180   Healthy Heart Guide

2001

In the next hour, 170 Americans will have a heart attack; 70 will die. That’s one heart attack  every 20 seconds, and one heart death every 51 seconds.  There are 1.5 million heart attacks each year: total cost $60 billion.  How do you avoid this?

Early Detection:
We’re getting closer to being able to find who’s going to get heart disease, and much earlier — before their heart attack or stroke.  And we can treat earlier, and more effectively.

<    Genetic Testing: many of you have had advanced cardio-vascular testing through our office from the Berkeley HeartLab.  These tests can help you, your brothers, sisters, children, and even parents know what their heart risks are and what to do about them.  The tests are drawn in our office by special arrangement.

<    High Frequency Carotid Ultrasound: A study by Dr. How-ard Hudis and colleagues at the University of Southern California (in the Feb 15, 1998 Annals of Internal Medicine) showed this painless, inexpensive study of the arteries in the neck could pick up people with early heart disease.  And frankly, if there’s disease in the arteries to the brain, treating helps prevent strokes at least, as well as heart attack!  This is available nearby in New York with NYU cardiologist, Dr. Michael Schloss, and in White Plains with Dr. Pesho Kotval.

<    Cholesterol Screening: A massive study of 6600 people in Texas concludes we should treat many more people than we have been under the guidelines of the National Cholesterol Education Program (NCEP). The Air Force Texas Coronary Atherosclerosis Prevention Study (AFCAPS/ TexCAPS) looked at men over 45 and women over 55 who had no known heart disease and low or normal “good” high density (HDL) cholesterols.  The “lousy” or LDL cholesterols were 130-190.  Treatment was with lovasta-tin (Mevacor). Those who were treated had 36% less risk of a first heart attack, angina or sudden death.  Women did particularly well, with 54% reduction in first events.  This study confirms an-other one done with pravastatin (Pravachol) in Scotland. Of great interest, the average LDL in the AFCAPS/TexCAPS trial was 150, below the NCEP’s suggested treatment threshold of 160.

Could Germs Help Cause Heart Disease?
Enticing reports that Chlamydia pneumon-iae might be involved in atherosc-lerosis are about to be tested. A recent small study showed that giving the antibiotic Zithromax for the common germ reduced the rate of second heart attack 5-fold in 18 months! Is this voodoo? Well, we now cure ulcers with antibiotics...

The Endothelium: Where the Action Is:
Imagine the lining of your arteries: the largest organ in your body: 1800 grams, and if spread out, enough to cover 6 football fields!  For more on protecting it, see the next page: