Cardiologists Providence RI

A Change of Heart

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By James Keough

Ever since the 1950s, when the Framingham Heart Study established a correlation between high cholesterol and heart attacks, doctors have focused on lowering cholesterol as a way to prevent heart disease. For years they’ve told us to accomplish this by eating a low-fat diet and exercising and, if that failed, by taking cholesterol-lowering drugs called statins. But as grim statistics keep piling up—79.4 million Americans have one or more forms of cardiovascular disease—an increasing number of doctors, some of whom call themselves the new cardiologists, have begun to question this single-minded approach.

Another statistic helps explain why: More than half of all heart attacks occur in people with normal cholesterol levels. That means their total cholesterol score is below 200 mg/dl, the limit set by the National Cholesterol Education Program in 2001. Does that mean you don’t need to worry about cholesterol? Simply put, no. “Cholesterol’s important,” says Stephen Devries, MD, associate professor of medicine, Division of Cardiology and Center for Integrative Medicine at Northwestern University, “but it’s one part. There are other metabolic risks that are not typically measured in most medical encounters.”

The new cardiology arose out of a collective realization that new opportunities existed for better (and earlier) diagnosis, creative noninvasive treatment, and even outright prevention. In redirecting their energies and practices—often at a significant loss of income since they perform fewer interventions—the new cardiologists use more refined tests that measure more than cholesterol. And they’ve developed new protocols for nutritional supplements to correct the imbalances those tests reveal.

None of them has completely abandoned the more traditional tools of cardiology, however. They instead seek to use them more appropriately and generally only after trying natural approaches. Devries says simply, “I’m very goal oriented, so I try natural approaches first, and if they don’t work and I believe that someone needs to get his cholesterol down, I move on to statins. And I think that’s a good thing. I’m glad they’re around.”

Old school
In the more conventional view of heart disease, elevated cholesterol levels in the blood create plaque in the coronary arteries, which causes them to narrow and become diseased. Doctors used to think the plaque itself blocked arteries and caused a heart attack, but they now know that a specific type of plaque ruptures and starts a chain reaction: Blood clots form to stanch the wound, and then part of the clot breaks off, dams up an already narrowed artery, and causes a heart attack.

Until recently, determining who had heart disease was difficult without actual symptoms, primarily chest pain, shortness of breath, and fatigue. So cardiologists put patients through a stress test (such as running on a treadmill) to see if they experienced pain or fatigue and to measure their heart function. Storie...

Author: James Keough

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