The World's Greatest (Ongoing) Medical Failures in 2011

In the United States alone, nearly 1 million people a year die of heart disease. Once a condition only of the rich, rates of heart disease are increasing all over the world, even as new cardiovascular medications and treatment techniques multiply.

The inability to prevent heart disease is perhaps the world's greatest ongoing medical failure. Heart disease begins in our teens but usually does not manifest itself until we are in our 60's and 70's, giving us 50 years or more to make the changes that may save our lives if only we know what to do. Here is what you need to do to maintain the health of your heart.

1. Assess your risk of heart disease.

The first step in preventing heart disease is getting an objective assessment of your risk of heart disease. Most doctors will insist on your having regular blood tests for total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol. The number that really predicts your risk of heart disease, however, is a fraction of the LDL cholesterol called apo-B.

LDL cholesterol is low-density because it consists of large particles. The largest particles, known as apolipoprotein A1 or apo-A1 particles, are big enough to act as "scrubbers" against artery walls. This kind of LDL doesn't cause heart disease. It actually prevents it.

There is another type of low-density cholesterol that is slightly denser and slightly smaller than apo-A1. It's known as apo-B. This is the kind of LDL cholesterol that can oxidize, calcify, and clog arteries. It's possible to have high total cholesterol and low apo-B so that you are at low risk of heart disease. It's also possible to have low total cholesterol and a high risk of heart disease. The numbers doctors usually measure don't tell the whole story.

Even if your total cholesterol, LDL cholesterol, HDL cholesterol, apo-A1, apo-B numbers are all in the healthy range, you may still benefit from taking statin drugs. The latest studies reveal that the way statins really prevent heart disease is by fighting inflammation. Chances are that you'll never know you suffer inflammation unless you have a blood test for a compound called C-reactive protein, or C-RP. If you have high C-RP, and about 10% of people who have normal cholesterol do, you still need statins. Some people who just have "high cholesterol," however, don't.

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2. Lower your risk of heart disease.

The second essential step to avoid becoming part of the heart disease statistics is doing something about your risk of heart disease. Statin drugs do sometimes help, but they are never enough to ensure good health. What else do you need for a heart-smart lifestyle?

• Keep your blood pressure within normal limits. Blood pressure pills, at least the kind you get outside of a hospital, usually won't lower your blood pressure by more than 5 to 10 "points" (mm Hg). To achieve normal blood pressure, you may need to lower your consumption of salt and canned or preserved foods, make sure you consume 5 to 9 servings of fruits and vegetables every day, learn breathing exercises or use an assisted breath exercise machine like RESPARATE, and control stress.
• Take good care of your teeth and gums. The bacteria that cause gum infections can escape into your bloodstream and cause inflammation there.
• Provide your heart with the nutrients it needs for survival. Taking coenzyme Q10 may not help you avoid a heart attack, but it may help you survive one.

Failing to Prevent the Consequences of Smoking

Less than 100 years ago, smoking was considered to be a healthy habit. Doctors sometimes even prescribed cigarettes to patients with the idea that it would help them control stress. In World War II, American soldiers, sailors, and marines were issued cigarettes along with beer and that ultimate military convenience food, SPAM and crackers.

For nearly 50 years, however, the medical establishment has been well aware of the consequences of smoking, heart disease, lung cancer, mouth and throat cancer, asthma, emphysema, and even rheumatoid arthritis. All of us, however, know people who smoke who don't get these dread diseases, and some of us know people get these horrible conditions but who did not smoke.

What makes the difference?

One difference is diet.

What doctors don't usually tell their patients is that healthy diet—although not always nutritional supplements—can offset many of the ill effects of smoking in many—although not all—smokers. Vegetables in the cabbage family, for instance, contain sulfur-bearing compounds known as isothiocyanates. The isothiocyanate in watercress, phenethyl isothiocyanate, is especially helpful for smokers. It neutralizes an enzyme in the liver that converts the nitrosamines in tobacco smoke into NNK, a cancer-causing chemical. About 10% of people, however, lack a gene that helps their bodies use isothiocyanates to fight cancer.

Smokers usually have low bloodstream levels of antioxidants. It's important not to get antioxidants from supplements. Smokers need to get their antioxidants from food. Smoking causes imbalances in antioxidants that can be made worse by taking supplements. A famous study in Finland in the 1990's found that giving smokers just beta-carotene supplements actually increased cancer deaths. Getting both alpha- and beta-carotene (what you get from eating a carrot rather than taking a beta-carotene supplement) decreases them.

It's not even a good idea for smokers to overdo fruits and vegetables. One study found that eating carrots and tomatoes every week lowered the risk of lung cancer, but eating them several times a day every day raised it. 

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And if you can't or don't want to quit, here are some things you can do to stay healthier:

• Treat seasonal affective disorder, the kind of depression that comes on in the fall and usually resolves itself in early spring. Caused by lack of sunlight, this kind of depression is treated by spending time under a sun lamp or in bright sunlight in the early morning. Smokers who don't treat seasonal affective disorder tend to smoke more in the winter.
• Don't smoke more just because your brand is labeled "silver," "gold," or "slim." These brands are just as harmful as any other cigarettes. Menthol cigarettes are no more likely to cause cancer than non-menthol cigarettes, but they can be harder to quit.
• Avoid smoking first thing in the morning. Smokers who light up within the first hour after waking up are 31% more likely to develop cancer.
• Don't smoke marijuana if you develop chronic obstructive pulmonary disease (COPD). Marijuana smoke is even more damaging than tobacco smoke, although other forms of marijuana are not.

Some smokers are blessed with the genetics that detoxifies carcinogenic chemicals in tobacco smoke. Other smokers are not. By 2015, it will be possible to identify toxic chemicals associated with a high risk of cancer in a urine test—so that smokers at higher risk of cancer can plan accordingly.