Heart Health More than “Taking Pills”

Thomas Hastings thought he was doing right by his heart.

He considered his diet to be pretty heart healthy, and he did some exercise. Still, he had high cholesterol and tests revealed that he had significant coronary artery disease.

Through his own determination, Hastings decided that he didn’t need surgery to heal his heart. He just needed motivation, medication and sound medical advice. He turned to K. Lance Gould, M.D., professor of cardiology at The University of Texas Medical School at Houston, for help.

Gould said motivation plays an important role in the reversal of coronary artery disease. Heart patients who are motivated to improve their health through diet, exercise and medication are three times less likely to suffer a coronary event than those who take prescribed drug therapies but don’t adopt a healthier lifestyle.

In an analysis of 409 patients with coronary artery disease, published Jan. 15 in the Journal of the American College of Cardiology, Gould, director of the Weatherhead P.E.T. Center for Preventing and Reversing Atherosclerosis, found that even though the motivated patients had worse heart defects at the beginning of their treatment, five years later, they had better outcomes than the comparison groups.

More than 93 percent of these patients remained heart healthy. Only 6.6 percent had suffered a coronary event that lead to bypass surgery, an interventional procedure, or other complication, including death.

Patients who took medication to control their cholesterol, but didn’t stick to a proper diet or exercise program had higher than a 20 percent chance of suffering a coronary event over a five-year period.

“People think that if they are taking pills to lower their cholesterol, its OK for them to eat steak and a piece of pie,” Gould said. “That isn’t the case. You can’t take your medication and still eat like a pig. You have to work out and eat right, and if you have coronary artery disease, you need to be taking statins and/or other lipid active medications to correct other blood fats such as triglycerides, the good cholesterol, and LDL, the bad cholesterol.”

Gould recommends a diet with a limited amount of carbohydrates and containing less than 10 percent of its calories from fat. Lean chicken, fish, turkey, pork and vegetables should be staples for patients with coronary artery disease.

It is important for patients to control their weight and exercise 30 minutes or more four to five days a week, Gould said. Equally important is taking lipid active drugs that are dosed specifically to help achieve high-density lipoprotein levels below 90 and good cholesterol levels higher than 45.

Gould said it is often difficult for patients to change their eating and exercise habits, but the more motivated they are, the easier the adjustment is.

Hastings is living proof of that.

Today, Hastings, who celebrates his 79th birthday this year, is the picture of health. He follows a low-fat, low-carbohydrate diet to help control his weight, and says he become a fanatic about exercise. On a recent day, he took a brisk, five-mile walk before heading off to a yoga class.

“My health is definitely better today than it was six years ago,” he said. “I no longer have unstable angina, and I have a bundle of energy.”

Bob Casson, 55, shares similar results. In 1999, a physician told Casson he needed bypass surgery. He got a second opinion from Gould, who prescribed a strict diet, increased exercise and statins.

Casson hasn’t eaten a fast-food burger since. He gets up at 4:30 a.m. every morning to do 500 stomach crunches. Every other day, he runs more than two miles, and he logs his running times and weight on the computer. It motivates him to keep his health in check.

Gould said intense lifestyle changes, like the ones Hastings and Casson made, have a profound impact.

“Your survival rate is dramatically improved if you do more than take some pills,” he said.

“We wanted to see if combining intense lifestyle and cholesterol-lowering drugs is better than usual care for coronary artery disease,” Gould said. “Indeed, it is better, and we hope this study will further motivate patients to take charge of their health, eat right, control weight and exercise.”

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©2006 Texas Medical Center

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