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From: B. Harris)
Subject: Re: What's WRONG With The Human Heart (electrically) ?
Date: 21 Feb 1999 18:12:50 GMT

In <> (j) writes:

>It's a fair question. I've seen a number of animal hearts completely
>removed, sitting in saline, still exhibiting a strong regular beat
>for quite some time.

Not mammal hearts, you haven't.

> But the HUMAN heart, seemingly at the slightest
>insult, either stops or goes into fatal arhythmia.

   Not at all.  Mice and elephants both get about a billion heartbeats
in a lifetime.  It's just that mice do it at 600 per minute for 3
years, while elephants go 30 a minute for 60 years.  If you look at
humans, you'll see we have excellent hearts.  You passed your billionth
beat around age 30, and the rest is gravy.  What looks to you like poor
workmanship is actually an unusually good design, with some damage by
bad diets.

>OK experts ... what IS it about the human heart which makes it so
>extremely succeptable to electrical disturbances ??? If it were
>a consumer product, it would have been recalled immediately as
>grossly sub-standard - a "lemon".

   No, it would have been a Mercedes.  Though most of us treat it
badly, only changing the oil every 40,000 miles.  It would last even
longer if we did it right.

>This is not an idle question, as an unfortunate number of patients
>with heart problems are sent home, only to die of sudden arhythmias
>days, weeks or months later - far away from technology adequate
>enough to save them. Only recently, Floridas governor, Lawton
>Chiles, dropped dead while excercising - the cause was NOT a MI
>but simple, sudden arhythmia. Even WITHIN hospitals, too many die
>from these problems when rhythm cannot be re-established in time.
>So many of these people are, in fact, in relatively good condition
>EXCEPT for the electrical condition of their hearts.

    Not really.  Most arrhythmias occur in people with coronary
disease.  Not all, but most.  The hearts of younger humans (age 30 or
40) are no harder to fibrillate than the hearts of animals which have
undergone comparable work.  Those who tried the first electric chair
execution in 1890, in fact, got a nasty surprise.  They guy they tried
to kill, a man named Kemmler, age 30, wasn't nearly as easy to kill as
the cats and dogs and assorted other animals (even a horse and an
elephant) they had tried AC current on, in tests.  They basically had
to fry him, and they basically had to fry everybody thoughout the
history of the chair's use.  They had to zap Ethel Rosenberg three
times, in fact.  There's a lesson in all that.

>More widespread use of implanted electronics will indeed reduce
>the death toll - assuming it is used fairly aggressively. But
>a great many will still die of a first heart-attack, of electrical
>shock, of chemical insult or of traumatic shock BEFORE they
>can reach medical help of any kind.
>What humans need is a "fix" - something which can be done with
>medication, simple surgery or prophylactic technology - BEFORE
>a heart rhythm problem happens. A "vaccination" of sorts. Those
>at higher risk, such as patients with moderate coronary artery
>disease, multiple medical risk factors, electricians/power-utility
>workers, selected atheletes, fire/rescue/law-enforcement/military
>personel and selected chemical/construction/hazardous-environment
>workers could benifit from prophylactic techniques so greatly that
>failure to do so almost amounts to malpractice.

    It's a nice idea, but humans are not especially fragile.  And the
resources to do this just aren't available.  We're having a hard enough
time getting defibrillators into every large congregation and sports

>Increasingly miniturized, "smart" and reliable implanted
>defibrillators and pacemakers are, of course, a good thing
>but it will be a while before such technology becomes small
>enough, reliable enough, safe enough and "smart" enough to
>be applied as cheaply and casually as a shot of penicillin.
>Other approaches may lie in ways to "reprogram" or "re-train"
>the hearts electrical system to make it much more stable under
>Huge amounts of money are spent investigating ways
>to deal with coronary plaques and occlusions, but for the
>most part, MIs actually kill by inducing arhythmias. What
>if they didn't ... ? What if a MI was painful, perhaps reduced
>cardiac output for a while, but did NOT cause arhythmias ???

    What if your grandmother had wheels.  Would she be a car?

>It would buy a lot of TIME ... time to rebuild muscle, time
>to re-vascularize, time to plan and implement the most
>appropriate medical and surgical interventions.
>Think about it.

     You, too.

From: B. Harris)
Subject: Re: What's WRONG With The Human Heart (electrically) ?
Date: 22 Feb 1999 01:17:23 GMT

In <> (j) writes:

>On 21 Feb 1999 18:12:50 GMT, B.
>Harris) wrote:
>>>Huge amounts of money are spent investigating ways
>>>to deal with coronary plaques and occlusions, but for the
>>>most part, MIs actually kill by inducing arhythmias. What
>>>if they didn't ... ? What if a MI was painful, perhaps reduced
>>>cardiac output for a while, but did NOT cause arhythmias ???
>>    What if you grandmother had wheels.  Would she be a car?
>   Add a carburator and some spark plugs ...
>   You seem to think we are necessarily STUCK with what we
>   have now. Not true at all. The first "fixes" will be
>   through microelectronics. There is absolutely no reason
>   a heart HAS to go into fibrillation or lose too much
>   effective contractile ability after a MI beyond the heart
>   being too "stupid" to cope with the changed conditions.
>   Nature ain't good enough ... but we can change that. Why
>   hand someone with coronary artery disease an asprin, some
>   nitro and a "good luck ... we'll consider angioplasty if
>   you have more symptoms". You know that in x-percent of the
>   cases "more symptoms" will be an unannounced thrombosis
>   at 4AM and the paramedics won't arrive in time. This doesn't
>   HAVE to be.
>   You ever seen "flexible" electronics ? Semiconductors and
>   wiring on thin plastic film ... F-16s are full of them.
>   It's the kind of stuff you can roll up into a little tube
>   and insert into someone through a large-bore hypodermic
>   needle. Manipulate a few little wires onto the right
>   parts of the heart, or perhaps actually stick the device
>   itself on the heart, and you have the makings of a "smarter"
>   heart - one which detects and corrects rhythm disturbances
>   which nature cannot cope with. Impending electrical chaos
>   could be suppressed before it got out of hand. Such technology
>   wouldn't even have to be very expensive.
>   OR you can go on talking about diets ... maybe some
>   homeopathic goop too ... as folks drop like flies all
>   around for lack of some (now) simple technological
>   intervention. "Nature" is not our friend - it simply
>   *is*. There is no reason to make your thinking a slave
>   to what "nature" can provide.
>   -j

    You do know about implantable defibrillators, do you not?  They
were once exotic, and are now common.  The problem is being worked on,
but since the FDA got hold of medical device development, the costs
have increased by order of magnitude, and so has the pace of
development (if the implantable defibrillator were proposed now, the
FDA would block it for the next 20 years).  Your basic problem is
political, which is to say: human nature.  People don't want what they
haven't seen.  The FDA keeps it from being seen.

                                         Steve Harris, M.D.

From: B. Harris)
Subject: Re: Doctor-bashing
Date: 4 Mar 1999 06:57:25 GMT

In <7bj9bh$jc0$> (George
Conklin) writes:

>>>   That does not leave much left to deal with, given the
>>>lack of progress against major adult cancers.  Heart disease
>>>seems to be falling, and has for 60 years for reasons
>>     Or rather, for reasons that have too many explanations. Correct,
>>it's not ICUs or coronary bypasses-- on the mortality curve you can't
>>see where those things arrive in the 1960s at all.  But that doesn't
>>mean it's not antihypertensive drugs.  Or a growing awareness of the
>>evils of smoking (which, when you stop, drops your cardiovascular risk
>>most of the way back to baseline in only a couple of years).
>   Antihyptertensive drugs?  The drop was well in place
>before they became common.

   Yes, but the problem with heart disease deaths before about 1960 is
that they weren't every well diagnosed. Without wide availability of
the EKG machine, it was pretty hard to tell why somebody who was ill
simply died.  Heart failure or "cardiac arrest" got put down a lot, but
it should be obvious that most people die of cardiac arrest,
ultimately.  In cases where it wasn't obvious that they were doomed by
some existant condition, or had been the victim of some obvious trauma,
cardiac arrest got used as a grap bag, and heart disease as a condition
took an undeserved beating.  As drugs like lidocaine and machines like
defibrillators came into routine use, also about 1960, so did the
need for ICUs (what point in noting cardiac arrest if there was nothing
you could do about it?).  In part, heart attack "deaths" have dropped
because of such monitoring-- an unautopsied person not thought to have
heart problems was more likely to be recorded as a death from pneumonia
or embolism or trauma if the EKG had been normal.  That didn't always
happen previously.

   I'd like to see you prove that the actual amount of heart disease
mortality was in decline before 1960.  And, again, I'm not talking
about deaths attributed to "cardiac arrest" or something stupid like
that on death certificates.  I mean with some stats about extent of
coronary disease on autopsy.  Antihypertensive drugs as we know them
arrived in the late 50's (rawulfia/Serpicil) and early 60's
(methyldopa/Aldomet).  Coronary disease was certainly well advanced in
the American population by that time (as shown by autopsies on Korean
war causualties vs Korean enemy casualties, a famous study).  If the
problem was nutrition it was overnutrition, since from autopies on
American civil war casualties (who had pretty clear arteries) we know
that coronary disease in young men was a relatively new phenomena that
had happened sometime between the 1860's and and the 1950's.  You are
going to argue that nutrition and clear water were better in the
1860's, then suddenly got worse, then better?  This should be very
entertaining.  Have at it.

From: B. Harris)
Subject: Re: Doctor-bashing
Date: 4 Mar 1999 15:51:30 GMT

In <7blrob$rrs$> (George
Conklin) writes:

>In article <7blasl$>,
>Steven B. Harris <> wrote:
>>   I'd like to see you prove that the actual amount of heart disease
>>mortality was in decline before 1960.  And, again, I'm not talking
>>about deaths attributed to "cardiac arrest" or something stupid like
>>that on death certificates.  I mean with some stats about extent of
>>coronary disease on autopsy.
>   Since you do not accept official data to base your
>opinions on, you are thus free to substitute personal

    Since doctors like me are the source of your "official data," and
in the absence of an autopsy (which is most of the time), use our
"personal opinions" to generate it, it would seem that your citisism
bites you in the rear either way you want to view it. If you don't like
my "personal opinion," you might explain how it is that it becomes
sacred "official data" the moment I put it on a state form and put my
name and license number on it?  After which you are willing to take it
as gospel truth, handed down by God?  How many death certificates have
YOU filled out?  Seen filled out after attending the patient?  Have you
ever even seen one filled out, ever in your life?  So whose personal
opinions here are more relevent?

> There is no way to answer this if you, like so
>many usenet readers, dismiss data.

   In this case, I generate that very "data."  I watch my colleages
generate that data.  I know the quality of it because I watch it made.
Now: what do you know?  And how do you know it?

> Autopsy is very, very rate today anyway so based on your criteria 98%
>of deaths are unexplained.

   Or, rather, are not explained to a high degree of acuracy.  And with
heart disease taking a lot of the scapegoating (for example, for many
large pulmonary emboli, which show up in an astonishing fraction of
autopsies, and were not expected or suspected).  If you'd like papers
showing that autopsy changes clinical diagnosis of cause of death
significantly, I'll be happy to provide them.  But I'm sure you can
look at medline and find many yourself.

   And that, please note, is in the modern era when we have frequent
EKGs and various cardiac enzymes to help with the diagnosis of death by
coronary disease, many of which were not routinely available before
1960.  And which, when available, were often not available in a way
which would help much with the question.  In 1960 how many patients do
you suppose who died in the hospital after being admitted ill with one
disease or another, did so while being actually hooked up to an EKG
machine (when there might be one or two machines in the entire place?).
Answer: mighty few.  How many died while monitored by cardiac
telemetry?  None-- -no such thing.   How many collapsed at home and had
EKG (ECG) and CPR applied by paramedics, in time to tell steak
aspiration from aneurism from sudden V-fib or embolism?  What
paramedics?  So the idea that deaths from cardiac disease were dropping
prior to 1960 is quaint, but difficult to back up without autopsy
series.  Which, if you have, you can guess trends from.

  (Thought actual numbers are more difficult, since even on autopsy
it's rather difficult to tell who died FROM coronary disease as opposed
to who died WITH coronary disease.  Clots can form after death.
Dysrhythmias can happen very quickly in ischemia (too soon to be able
to see tissue changes), and you can't find a dysrhythmia on autopsy.
Basically, let me remind readers, all autopsy series do is tell you
that incidence of some pathology, and presumably deaths from it, is
changing.   But the absolute numbers are not very reliable.)

                                        Steve Harris, M.D.

From: Steve Harris <>
Subject: Heart Disease As 20th Century Phenomenon. Re: New Autism Cases Level 
	Off in California, Data Show
Date: 28 Jul 2005 12:24:41 -0700
Message-ID: <>

Donna Metler wrote:
> "TC" <> wrote in message
> >
> >
> > Happy Dog wrote:
> > > "TC" <> wrote in message news:
> > > > Steve Harris wrote:
> > > >> TC wrote:
> > Real fresh whole food, which contains the maximum amounts of vitamins,
> > minerals, etc. Fresh produce, fresh chicken, seafood, pork, beef, lamb,
> > etc. Bone broths, real fresh raw dairy. Real food like our
> > grandparents, or great grand-parents used to make. You know, like back
> > at the turn of the twentieth century when only a few people got
> > diabetes t2, heart disease and obese. As opposed to today when we eat
> > all kinds of manufactured and refined crap and we've experienced a
> > tripling of chronic disease and obesity in the last thirty years.
> >
> And where people statistically died much earlier, which meant that diseases
> related to aging didn't have a chance to occur. Or have you forgotten that
> little point?


When it comes to cancer you're probably right--- the big changes in
cancer rates in the last century are basically due to 1)
smoking-related stuff (big increases in males starting 20 years after
cigarette rolling machines invented circa 1920, with the increases in
women 20 years following WW II (when women started smoking in public).
There's a big decrease in gastric cancer which probably has to do with
more refrigeration and less smoked foods. And a small increase in
lymphomas and leukemias in children, which may well be environmental,
but there are about a hundred suspects. Nothing to really pin on diet.

For diabetes II, there's no doubt there's more. We eat too much, the
cause is cheap easy high-cal fast food and junk-food, and that's that.
But you can blame the price and caloric density and there's no need to
be more complex than that.

For heart disease, we clearly did something very bad in the US toward
the middle of the 19th century, and it was probably related to diet.
Civil war dead (men about age 20) autopsied had no heart disease. But
by Vietnam, our US dead had significant coronary disease in a third of
soldiers. These young men were no older, and only a little fatter, than
they'd been a century ago.  Something very wrong with diet there. The
Vietkong dead autopsied along side them, STILL had no heart disease at
a comparable age.

So TC is right that there's something wrong. But it could as well be
trans-fats and not enough folate and omega-3's. We don't know what it
is/was, except it's Western, and it's recent. Again,there are about a
hundred suspects.

A lot of mystery, and too many people who "know" the answers. But the
beginning of wisdom is admiting the problem AND admitting you don't
have a solution. When it comes to heart disease, we're still flopping
around red-faced in a way that reminds me of NASA and the booster tank
insulation. But that's okay. There's no SHAME in that. It's a hard
problem, is all.


From: Steve Harris <>
Subject: Re: The Final Word on Nutrition
Date: 31 Aug 2005 14:35:14 -0700
Message-ID: <>

Juhana Harju wrote:
> Visual Purple wrote:
> : 6. Ukrainians drink a lot of vodka, eat a lot of perogies, cabbage
> : rolls and suffer fewer heart attacks than the Americans, Australians,
> : British, or Canadians.
> Your data is not accurate. Ukrainians do not drink a lot, nor is their CHD
> mortality low. You can check the data from the file below: pages 26 and 68.
> : CONCLUSION: Eat and drink what you like. Speaking English is
> : apparently what kills you.
> Speaking English as mother tongue correlates with bad diet.


That is pretty much true, but only because the English (and Nordics in
general, which includes the UK after the Norman conquest) live in
places where they tend to get cold-weather diets which don't include
fish. That's a prescription for heart disease.

Epidemiologically, heart disease is really not as much about what you
eat, as what you DON'T eat. Coronary disease is generally prevented by
fresh fruits (including grapes and wine), vegetables, and marine foods.
Show me a population that gets few fruits and vegetables and marine
products, and I'll show you one with a lot of heart disease. Many of
these are English-speaking for historical reasons (the English tended
to colonize the North), but the Ukranians, the Finns, the Russians and
the Swedes, all qualify without speaking English. On the other hand,
many other Northern peoples (various Eskimos, northern coastal peoples,
Koreans, Icelanders, Japanese) are saved from high heart disease
incidence by their marine intake.

If you get your calories from non wine alcohol, agricultural meat,
milk, grain and potatoes *without* getting much fresh plant food or
fish, and you're in trouble. The problem is that then, farm meat,
milkfat and refined flour, sugar, and potato starch get blamed! Which
is how we got into the refined foods argument. And also how we got into
the sat-fat scares.

But it is NOT the saturated fat intake per se, but the Sat-fat/PUFA
ratio which predicts cholesterol blood picture and heart disease
population risks, and THAT in turn is basically a proxy for your % cal
intake of plants and/or fish. We looked at what was there, when we
should have been looking for what was missing. The Mediterranean
"paradox" was PRECISELY that somebody noticed that the mediterraneans
were eating all those bad starches, meats, saturated fats, and so on,
and still not getting heart disease. But they ate the protective stuff
ALSO, and that's the key.

Alcohol replaces other calories (including those from plants and fish),
and is probably thereby a mild negative--- except that alcohol itself
is antiatherogenic in animal models. But epidemiologically alcohol
doesn't really count much, unless it's wine.


From: Steve Harris <>
Subject: Re: The Final Word on Nutrition
Date: 31 Aug 2005 19:54:49 -0700
Message-ID: <>

montygram wrote:
> People in northern Europe tend to eat the fish that is very high in the
> supposedly very healthy omega 3 PUFAs.

No, in fact they do not. Fish consumption is relatively low in Finland.
It is higher in Norway, and as it has recently increased, Norwegian
heart disease has dropped. It is highest in Iceland, where heart
disease rates are low.

 > The root cause is oxidative
> stress.  Every study I've seen demonstrates this, except for a handful
> of studies that were very poorly conceived (such as those on "vitamin
> E," which use only one form, thereby leading to deficiencies in the
> other forms).

I have personally posted for you a dozen abstracts showing that omega-3
supplmentation DECREASES oxidative stress (mainly by interrupting
inflammatory mechanisms which release oxidative mediators). Your point
is at best irrelevent, and at worst, wrong. Fish decreases heart
disease AND oxidative stress. Get used to it.

> Dr. Richard Stein, a spokesmang for the AHA, recently
> made clear that oxidized cholesterol is the problem,

Baloney. I've asked for this cite multiple times. One spokesman for the
AHA does not counter dozens of reviews in Circulation. Stein, however
he is, is not God.


Tidsskr Nor Laegeforen. 2004 Jun 3;124(11):1532-6.

Comment in:
    Tidsskr Nor Laegeforen. 2004 Aug 26;124(16):2153; author reply
    Tidsskr Nor Laegeforen. 2004 Oct 7;124(19):2517.
    Tidsskr Nor Laegeforen. 2005 Feb 17;125(4):470.

[Diet changes and the rise and fall of cardiovascular disease mortality
in Norway]

[Article in Norwegian]

Pedersen JI, Tverdal A, Kirkhus B.

Institutt for medisinske basalfag Avdeling for ernaeringsvitenskap,
Universitetet i Oslo, Postboks 1046 Blindern, 0316 Oslo.

BACKGROUND: Cardiovascular disease mortality in Norway during the last 50
years has been analysed and related to changes in dietary habits and
serum cholesterol in the population. MATERIAL AND METHODS: Mortality and
dietary data have been collected from official statistics. Changes in
serum cholesterol have been estimated from changes in intake of fatty
acids based on published regression equations. Data on changes in serum
cholesterol and blood pressure are from the former National Health
Screening Service. RESULTS: Mortality from ischemic heart disease (IHD)
peaked in 1966-70 when it was 100% higher than in 1951-55 for men and 50%
higher for women. For age group 40-69 years mortality has been reduced by
more than one half during the last 30 years. For the period 1996-2000 and
for all age groups, 30,903 fewer deaths occurred than expected, had the
mortality remained the same as during 1971-75, that is 6180 per year.
Mortality from sudden death has followed the same pattern as for IHD.
Cerebrovascular disease mortality has shown a declining tendency during
the entire period.  Since 1960 the proportion of total fat in the diet
has been reduced from 41 to 34% of energy and the proportion of
unsaturated to saturated plus trans fatty acids has increased.
Cholesterol in the diet has been reduced by almost one half.  Based on
changes in consumption in milk fat, fat from meat and margarine, and
taken into consideration the change from boiled to filtered coffee the
estimated reduction in serum cholesterol in the population is in the
order of 0.8 mmol/l.  This corresponds closely to the observed 0.5 to 1
mmol/l. Most of the reduction is due to changes in milk fat and margarine
consumption and composition.  INTERPRETATION: Based on the established
relation between serum cholesterol and risk of IHD we conclude that
reduction in serum cholesterol may explain most of the decline in
mortality since 1970. Other factors that may have contributed are reduced
smoking (in men), a small reduction in blood pressure, increased
consumption of fruit, vegetables, cod liver - and fish oil and better
means of treatment.

PMID: 15195160 [PubMed - indexed for MEDLINE]

From: Steve Harris <>
Subject: Re: EDTA
Date: 23 Aug 2005 19:33:36 -0700
Message-ID: <>

Eric Bohlman wrote:
> Steve Harris <> wrote in
> > Though I agree with your general point of view, presumably it doesn't
> > apply to EDTA and coronary disease. How in th devil are you going to
> > know it worked? Have two serial angiograms?  Serial spiral CTs?
> The testimonials always say that the patients *felt* better after the
> chelation.  To that, I would reply that five of the most boring days of my
> life were spent in the CCU waiting to be sufficiently anticoagulated to
> undergo catheterization, which revealed that my circumflex artery was 90%
> blocked.  I *felt* perfectly fine, except for a slightly annoying sensation
> in my chest that only occurred on the first day (and was the reason I was
> there, after convincing myself that it needed to be looked into, in the
> first place).  In the preceding days/months/years I was completely
> asymptomatic despite the fact that the blockage obviously wasn't anything
> terribly new.


Of course. Coronary disease, unless you're having an actual MI, is a
chronic disease like emphysema or any other. You have good days and bad
ones, and there's no rhyme or reason. Placebo effect is huge, and just
random deviations in heart pain are huge, for no particular reason. And
as for treatment, people feel better no matter what nasty thing you do
to them. In fact, in non blinded studies, the worse the treatment is,
the better people seem to feel later.

All of this drove the early heart surgeons and stenters nuts, and there
are famous trials of several heart procedures which involved actual
sham surgeries, where they cut the patients open and then sewed them up
again, sometimes doing the surgical procedure in between or not,
according to randomization.  There was one treatment called "Poudrage"
from the French for "powdering," in which irritant talc was sprinkled
on the heart to try to stimulate new vessel growth. It finally had to be killed by a
double blind experiment. As did internal mammary ligation, which was
supposed to benefit cardiac circulation. That was a killed finally by a
double-blind surgery trial in 1959:

And so on. Why don't I trust the testamonials for EDTA?  Because I know
too much history.


From: (Steve Harris
Subject: A modifiable 9 Factors account for 90% of total heart disease risk
Date: 30 Aug 2004 14:24:59 -0700
Message-ID: <>

Your Heart Disease Risk Is 90% In Your Hands

There's not much you can do about your age or gender. But take comfort
in the fact that age and gender don't doom you to a heart attack. Some
people never get heart disease (which is mostly from coronary
atherosclerosis) no matter how old they get. And age and gender *per
se* (as broken out from obestity, diabetes, hypertension, etc that go
along with age *if* you eat wrong), are the cause of less than 10% of
heart disease risk.

Recently, results from a very large epidemiologic trial (INTER-HEART),
which follows 27,000 people in 52 countries, has been reported at the
European Society of Cardiology meeting, which is going on in Munich,

The results are pretty much the same-old stuff, but they do emphase a
couple of interesting things. First, is that any genetic factors you
have that DON'T relate to easily measurable things like diabetes,
blood pressure, and your cholesterol picture, aren't all that
important, because they explain only 10% of heart disease. Remember,
that 10% includes the entire effect of age and gender, too. That means
it's possible go to your doctor and get a pretty complete risk
assessment right now. It's not perfect, but we can say it's 90%
accurate. That's pretty good. It's also pretty neat that no matter how
hold you get, you can still (probably) modify your life to avoid at
least 90% of your heart disease risk. If you start young, that is. We
don't yet know, of course, how late is "too late" for some of these
things. For example, 30 year-olds get the full ten years of extra life
if they quit smoking, but it's only 6 years for 50 year olds who quit,
and 3 years for 60 year olds, etc.

Second, this is the first time I've seen LACK of alcohol intake listed
as a bona fide cardiac risk factor. It made the top 9!  Mormons and
Seventh-Day Adventists are really going to hate this. Sorry, but red
wine is here to stay. The French rule, here (now if we could only get
the French to stop smoking and start bathing).

FYI, the top 9 modifiable heart disease risk factors in INTER-HEART,
which account for 90% of total heart disease:

1) Smoking
2) Abnormal cholesterol (apo-B/Apo-A1 ratio, which is similar to
LDL/HDL raio)
3) Diabetes
4) Hypertension
5) Stress
6) Abdominal obesity (yow, that gut will get you)
7) Sedentary lifestyle
8) Eating too few fruits and vegetables
9) NO alcohol intake

Read that last one again. The other stuff is the same old grugery, but
dark chocholate and wine (in moderation) are still mighty fine.


From: (Steve Harris
Subject: Re: A modifiable 9 Factors account for 90% of total heart disease risk
Date: 1 Sep 2004 20:56:29 -0700
Message-ID: <>

Mark & Steven Bornfeld DDS <> wrote in
message news:<>...

> 	Not sure I'm understanding the statistics.  You say that genetic
> factors NOT related to diabetes, blood pressure, and blood lipid profile
> are only responsible for 10% of heart disease.  I don't see how this
> translates to "you can still (probably) modify your life to avoid at
>  > least 90% of your heart disease risk. "
> 	Even if your premise is true that these risk factors are responsible
> for 90% of heart disease, your conclusion seems suspect unless you
> assume that these factors are 100% controlable.
> 	Mind you, I'm all for healthy living.  I just think there should be
> some balance as to how much blame we put on patients for not having
> perfect control.
> Steve


We should remark on the difference between controllable in theory and
controllable in practice.  In theory there's no difference between
theory and practice, but in practice, there is. :)

If I could put all people with DMII and dyslipidemia in a box and they
had to eat only what I fed them, I have little doubt I could put the
LDL and triglyceride and A1c of at least 90% of them just where I
liked. I can also give everybody a BMI of 21 or 22. Smack on, whatever
you like. The problem is that real people aren't on a locked metabolic
ward, and they cheat. So do we count that, or not?

My personal experience is tainted a bit by doing a study on the guys
who went into Biosphere II at 1500 kcal a day for 2 years. They went
to cholesterols of 125 (about the same as in rural China) and their
fasting glucoses were about 70. Blood pressures were down to systolics
of 110 or so. They were damn skinny, and nobody had anything had
perfect numbers that any internist would salivate over.

These guys weren't locked in, but they were put in with a lot of seals
and stuff that they would all have paid heavily in self esteem to
break. No cheating and sending out for pizza in Biosphere II. They
paid for their extreme diet by being tired and cross, too. I'm sure
the same is true in rural China.

In the real world, only a fraction of people would have to be that
extreme, now that we have meds that change your LDL and blood pressure
and glucose so nicely. I, for example, chronically need to lose 20
lbs. And I might even have done it, if it weren't so easily possible
to put my BP and LDL in perfect range, pharmacologically. And by
replacing one meal a day with a shake made of only good fats, whey
protein, and mixed frozen berries (ie, a perfect meal). My point being
that the locked metabolic ward is a last resort, rarely needed. But
yes, we do have nearly total control over the bad numbers, if we want
it badly enough.


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