Over my greater than 35 years of heart or vascular disease experience, I have seen a big discrepancy between my observations and the claimed common knowledge espoused by our media and discussed incessantly at all kinds of social gatherings. My experience, contrary to common belief, is that all kinds and sizes of people suffer from cardiovascular disease. The assumption made by many is that if you exercise regularly, eat a healthy diet and maintain ideal body weight you will be free of cardiovascular disease. Naturally we all should be following a healthy lifestyle. Unfortunately that is just frequently and not always the case although healthy lifestyle people certainly have an advantage over those with a poor lifestyle.

Your own experience tells you that this is not true. Jim Fixx wrote a book about exercise and healthy lifestyles and succumbed  while running to cardiovascular disease. How many times have you heard about a friend or family who appeared to be a very low risk suddenly die of heart attack. Why? They did not have the ideal genes for the prevention of cardiovascular disease. To which group do you belong?

My website has the story of what I consider to be a medical miracle. A 33-year-old gentleman with ideal body weight, despite his cholesterol being well below 200, at the age of 33 developed in his words "Angina". After two years of multiple coronary interventions at the best institutions around the country, he was advised he had run away heart disease and nothing more could be done. Then he his wife with a one-year-old lost all hope. after two years of hell he was then referred by Dr. Dean Ornish to a heart attack prevention specialist, Lipoproteinolgist 3000 miles away. Today that man has lived to see his children grow up into fine adults.

Throughout the years in my practice, the ratio of obese or overweight individuals as opposed to ideal body weight with coronary artery disease was 2 to 1.Over my career there were overweight and obese individuals whose blood test revealed intermediate risk no matter what they did. Therapeutic lifestyle changes did little to change risk. However as these people approach their 70s their risk did climb. These people in their 70s would suffer more from the disability of being overweight than actual heart attacks. Despite obesity these people have a slowly progressive vascular disease. Unfortunately of these most still develop usually asymptomatic cardiovascular disease unless they are in the best 15 to 20% for risk. 

A second group of individuals who are at ideal body weight had intermediate risk advanced lipoprotein parameters but became high risk when gaining just 5 to 10 pounds. Therapeutic lifestyle changes are necessary for this group. If weight loss proves not to be complete, medications are needed.

Another group of individuals with ideal body weight had very high abnormal risk. Therapeutic lifestyle changes would never help this person. This pattern is in the United States is more common in the new Middle East immigrants than Caucasians. At present, medications  are the most effective means to alter the expression of the disease producing genes to most favorable levels.

These different groups and each individual all need to have individually tailored therapy.

Therapeutic lifestyle is a given. All we can do is advise. Dr. Mehmet Oz is frequently seen on television as a promoter of healthy lifestyle. However, the people on his show exemplify the failure of our society. If I took all the recommendations of Dr. Oz and employed them in my life, I would have a much greater difficulty maintaining my weight than I do now. But unfortunately most people live by the lifestyle they learned as children and despite their best intentions, urged on by moneymaking corporations, easily revert to their previously learned childhood pattern. In order to help these people we  should work with their lifestyles.  However, altering the lifestyle is usually temporary not complete for prevention, they usually revert to their early learned habits.  In order to really help these people, there must be a another alternative, enter Cardiovascular Risk Reduction USA