Off Topic – Heart Disease Contributors

Dr. Rassman,

Off topic, but as a former doctor working in the heart field and as a doctor who worked in the cardiac field what do you think are the biggest contributors to heart disease? Is there any one variable (e.g., high cholesterol, smoking, diabetes) that is most dangerous?

This is not a simple answer for a blog post. I will give a cursory answer to it nonetheless in the hope that what I have to say will help someone and possibly could even save a life. Apologies to those that come here for hair related posts, but this isn’t one of them.

Putting aside congenital heart disease, the things that are most dangerous for developing heart and vascular disease are the lifestyles and diets we have. There’s no one factor that I would be willing to pinpoint. What I tell people who ask heart related questions is that we are dealt a set of genetic cards… and if we win, it reflects the way we play those cards. If we keep ourselves healthy (good diet, exercise, no poisons in our system like cigarette smoking or excessive alcohol) we will live longer.

Some people are genetically programmed for high cholesterol and high body fats, so we must take control of those bad cards by going that extra mile. For example, the vegetarian who eats fruits and vegetables daily will have a lower cholesterol and lower body fat than the meat eater who sucks in daily milkshakes instead of water and consumes excessive calories with Big Macs a few times each week. Even the insulin dependent diabetic can improve his card deck with a good exercise program and controlled diet under good medical supervision. I’m not blowing any minds by saying this, I realize, but perhaps there’s one person out there that it’ll click with.

Just remember, life is fragile and you never realize it until you are given the bad news (like a cancer that you ignored when you notice rectal bleeding over the past few years or develop chest pain with your first heart attack). Those of you who think that your body is impenetrable, waking up with chest pain may indicate that you could be too late.