DOCTOR'S VIEW ARCHIVE


Topic: Heart Attack Prevention

Dr. Lee:
Any promising though not yet proven measures that may prevent heart attacks?

Dr. Gregory Thomas:

I think we have figured out about 60% of the causes of arteriosclerosis that can lead to heart attacks or strokes. There is another 40% of the causes (and theri prevention) that still need to be established. For example:

  1. Antioxidant vitamins such as vitamins C and E theoretically can decrease atherosclerosis. But clinical trial results have been conflicting, thus more studies need to be done to determine whether they are effective in preventing heart attacks.

  2. Homocysteine is a waste product from protein. Homocysteine is probably toxic to the arteries. Patients who have elevated homocysteine blood levels have higher chances of heart attacks. Therefore, lowering homocysteine blood levels should theoretically decrease heart attacks. But controlled clinical trials are needed to prove that lowering homocysteine will actually prevent heart attacks.

  3. Inflammation or infection (such as chronic bronchitis due to chlamydia pneumonia that occur in cigarette smokers) have been shown to increase the blockage of the arteries and chances of heart attack.

  4. Genetic factors that we do not yet understand will cause heart attacks. For example, some people will develop coronary heart diseases even when the known risk factors are absent. We also still do not have a full understanding of the aging process. Even by maintaining low cholesterol, not smoking, maintaining good blood pressure, and doing all the right things to reduce risks, we still cannot stop the aging process. Best we can hope for is to delay it. Aging and genetic factors are areas we need to study to further our abilities to prevent heart attacks and strokes.

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Last Editorial Review: 8/30/2000